Giving medicines safely with food or thickened fluid

Karoline Brennan, Senior Medicines Information Pharmacist, North West Medicines Information CentrePublished

Use food and fluid of correct consistency or texture (IDDSI level) and that does not interact with the medicine; our tips help you achieve this for patients.

General advice

Preparing and giving medicines for people with swallowing difficulties

Before manipulating a medicine or giving a medicine with food or fluid, check it is safe and appropriate to do so and follow our advice on safe manipulation.

Which food or fluids to use

Texture

The food or fluid must be the appropriate texture for the patient. If the patient has had a swallow assessment, check what IDDSI Level of food texture or fluid consistency was recommended.

Heat

The food or fluid should be cold or warm, not piping hot.

Choices

Yoghurt, custard and apple puree are common choices. Some hospital wards and care homes keep tubs of yoghurt or apple puree specifically for administering medicines.

Bitterness

Crushed tablets or capsule contents may taste very bitter. It can be helpful to mask the taste of these medicines by using a strongly-flavoured food (e.g. chocolate custard) or thickened fluid (e.g. blackcurrant squash that has been thickened).

Milk

A few medicines should not be given with milk. The dispensing label will say if this is the case. Avoid using yoghurt or custard to give these medicines. Apple puree would be a suitable alternative.

How to safely give medicines with food or thickened fluid

General points

  • Instructions to crush tablets or open capsules, and administer with soft food or thickened fluid should be included in the patient’s MAR chart or care plan, and ideally on the medicine’s dispensing label.
  • Not all tablets can be crushed or capsules opened and it is important this has been checked and documented.
  • Not all medicines can be given with food. The dispensing label will say if food or milk has to be avoided before or after taking the medicine. If in doubt, check with a pharmacist.
  • Homecare and care home staff may only administer prescription medicines on the instruction of the prescriber and must be trained and competent to do so.

Prepare and give medicines one at a time

  • Prepare medicines one at a time. Do not crush all the patient’s medicines together.
  • Once prepared, give immediately.

Use a small amount of food or thickened fluid

  • Use a small amount of food or thickened fluid (e.g. a teaspoon) to ensure the full dose is taken.
  • If taken with a meal, the medicine should be added to the first mouthful of food, not sprinkled over the whole dish.
  • Do not add a medicine to a whole glass of thickened fluid.

Other specific areas

Understanding why people take medicines with soft food or thickened fluid

Giving medicines this way can be a safe and practical option for people with swallowing difficulties, with their knowledge and consent.

Manipulating medicines for administration to adults with swallowing difficulties

How to disperse tablets in water, crush tablets and open capsules safely for adults with swallowing difficulties.

Learn more

Swallowing difficulties

All our advice on using medicines safely and effectively in patients with swallowing difficulties